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Essentials of Chinese Medicine Zhanwen Liu Editor Liang Liu Associate Editor Warner Fan English Consultant Shiping Zhang Associate English Consultant EditorialTeam BaixiaoZhao ChunguangXie CunkuChang HaihongZhu HongyiHu KuiWang LanzhengLi SongpingLuo YuxiangZhai ZhaoxiangBian Essentials of Chinese Medicine Volume 1 Foundations of Chinese Medicine 123 Editor AssociateEditor ZhanwenLiu LiangLiu Dept.HealthPreservation&Rehab SchoolofChineseMedicine BeijingUniversityofChineseMedicine HongKongBaptistUniversity 11BeisanhuanEastRoad KowloonTong Chaoyang100029,Beijing Kowloon PRChina HongKong/PRChina [email protected] [email protected] ISBN978-1-84882-589-5 e-ISBN978-1-84882-590-1 DOI10.1007/978-1-84882-590-1 SpringerDordrechtHeidelbergLondonNewYork BritishLibraryCataloguinginPublicationData AcataloguerecordforthisbookisavailablefromtheBritishLibrary LibraryofCongressControlNumber:2009926514 (cid:2)cSpringer-VerlagLondonLimited2009 Apart from any fair dealing for the purposes of research or private study, or criticism or review, as permittedundertheCopyright,DesignsandPatentsAct1988,thispublicationmayonlybereproduced, storedortransmitted,inanyformorbyanymeans,withthepriorpermissioninwritingofthepublish- ers,orinthecaseofreprographicreproductioninaccordancewiththetermsoflicensesissuedbythe CopyrightLicensingAgency.Enquiriesconcerningreproductionoutsidethosetermsshouldbesentto thepublishers. Theuseofregisterednames,trademarks,etc.,inthispublicationdoesnotimply,evenintheabsenceofa specificstatement,thatsuchnamesareexemptfromtherelevantlawsandregulationsandthereforefree forgeneraluse. Thepublishermakesnorepresentation,expressorimplied,withregardtotheaccuracyoftheinformation containedinthisbookandcannotacceptanylegalresponsibilityorliabilityforanyerrorsoromissions thatmaybemade. Coverdesign:eStudioCalamarS.L. Printedonacid-freepaper SpringerispartofSpringerScience+BusinessMedia(www.springer.com) Foreword TheEssentialsofChineseMedicineisatextbookintendedforinternationalstudents whowishtogainabasicunderstandingofChineseMedicine(CM)attheuniversity level. The idea of writing such a text was originated from the Sino-American Consortium for the Advancement of Chinese Medicine (SACACM), which was foundedinFebruary2000.In1995,theBritishHongKongAdministrationsetupa PreparatoryCommitteefortheDevelopmentofChineseMedicinetolookintoways ofbringingChinesemedicalpracticeandherbaltradeunderpropercontrolandreg- ulation. After the reunification of Hong Kong with mainland China in 1997, the GovernmentoftheHongKongSpecialAdministrativeRegioncontinuedtheefforts toupliftthepracticeofCMtoafullyprofessionallevelthroughlegislation. To help bring up a new generation of professional CM practitioners, the Hong KongBaptistUniversity(HKBU)obtainedapprovalfromtheGovernment’suniver- sityfundingauthoritytodevelopaSchoolofChineseMedicinetopreparestudents who will meet the future professional requirements through public examinations. In order to establish itself quickly as a rigorous provider of university level CM education,HKBUsoughtalliancewitheightmajorCMuniversitiesintheChinese Mainland, and one US university which was interested in developing CM education within its medical college. As a result, the Consortium known as SACACM wasformed,withtenfoundinginstitutionsfromBeijing,Shanghai,Nanjing,Shan- dong,Guangzhou,Chengdu,Heilongjiang,HongKong,andtheUnitedStates.(The University of Macau and the Macao University of Science and Technology joined theConsortium2yearslater.) One of the firstprojects the Consortium decided topursue was the writing of a highqualityCMtextbookinEnglishtobeendorsedbythememberinstitutionsas the foundation for the study of traditional Chinese medicine. The Beijing Univer- sityofTraditionalChineseMedicine,beingoneoftheoldestandbetterdeveloped institutions in the field, was nominated to be the coordinating university for the project,withtheactiveassistanceoftheStateAdministrationofTraditionalChinese Medicine of China (SATCM). The initial funding for the project was provided by the Hong Kong Baptist University and the Ohio University of the USA. An edito- rialcommitteewasformedtodecideonthegeneralcoverageandlevelofthetext, andeachofthememberuniversitiesofCMwererequestedtonominatetheirsenior professorstowritetheassignedchaptersaccordingtotheirfieldsofspecialty.These v vi Foreword authors were to prepare their scripts in both Chinese and English with the help of the Editor. After the English version of the text was checked against the Chinese versionforaccuracyandconsistency,itwassenttoanexpertwhoiswellversedin bothChineseandWesternMedicineandatthesametimefluentinboththeChinese andEnglishlanguagesatthemothertonguelevel.Theexpertwasinvitedtogoover the entire text line by line to make surethat both the language style and the terms usedareunderstoodbytheinternationalstudentswhosenativelanguageisEnglish. Theabovestepslookedinnocentenough,buttheexecutionoftheentireprocess was extremely time consuming and tedious. It has also proven to be a very mean- ingful, if not “ground-breaking,” move which makes the text truly different from publicationsofsimilarnature.Iamhappythatafter9yearsofhardworkandperse- verancethistextisfinallyreadyforthepress.Idohopethatwhenitcomesout,it willprovetobeasignificantcontributiontotheeducationofCMinternationally. FoundingChair,SACACM DanielC.W.Tse February2009 Preface “Healthforall”isstillanimportanttaskfortheWorldHealthOrganization(WHO) toaccomplishinthetwenty-firstcenturyTheaccomplishmentofthistaskrequires mutualcooperationandcommoneffortsofvariousmedicalsciences,whichincludes Chinese medicine. WHO has increasingly emphasized the development of traditional medicine and has made great efforts to promote its development. Because traditional medicine is deeply rooted in history and culture, it is part of the tradi- tions of a country and employs healing practices handed down from generation to generation. Large portions of the population in a number of developing countries still rely mainly on traditional practitioners, including traditional birth attendants, herbal- ists,andbone-setters,andlocalmedicinalplantstosatisfytheirprimaryhealthcare needs. Although modern medicine is now available in many countries, traditional medicinehasmaintaineditspopularitybecauseofitshistoricalandculturalimpact. Peoplebelieveinit,anditisstilleffectiveagainstmanycommondiseases,hasfew sideeffects,andiseconomicallypreferabletomodernmedicine. Nowadays, the modern medical model is changing Itis gradually shifting from its original medical model of biomedicine into a physiological–psychological– sociological–medical model, which emphasizes that the people the natural envi- ronment, ecological conditions and society are allaspects of a united whole. With thetransformationintothenewmedicalmodel,alternativemedicineandtherapies are developing very rapidly. The study of Chinese Medicine (CM) in the west is both timely and challenging. It is timely because of public demand for traditional medicines to be provided by safe, efficient and competent practitioners. It is challenging because of the greater demand for science-based treatment and evidence-based practice. These perspectives suggest that the integration of ortho- dox medicine with complementary or alternative medicine is a historical trend in theworldmedicalscene.Therefore,theroleofCMinmedicaltreatmentandhealth- care will certainly become even more important in the world medical scene in the twenty-firstcentury. CM is an integral part of Chinese culture. Over the centuries, various activities andaspectsofthepracticeofCMhavemadetremendouscontributionstothepros- perity of the Chinese nation. Its good reputation resulted from its great vitality is vii viii Preface demonstrated by the fact that when compared with other traditional medicine its clinicalapplicationhasneverdeclinedoverthepastseveralthousandyears. CM appears to have a bright future in the world There appears to be a grow- ing reliance on itby people everywhere. This seems to be an irresistiblehistorical trend.WorkingtogethertodevelopCMwillnotonlybeinlinewiththedeveloping trendintheworld,butalsowillfundamentallysolveexistingproblemsandincrease competitive advantages. Collaboration among universities will benefit cultural ex- change,theblendingoftheEastandtheWest,andtheglobaldevelopmentofCM. However,muchworkneedstobedoneinordertomeetthehealthrequirementsof human beings and to promote the course of internationalization of CM, especially the compilation of textbooks suitable for medical students in western countries in additiontointernationalreaders. With the encouragement of the State Administration of Traditional Chinese MedicineofChina,thecompilationofthistextbookserieswasinitiatedbytheSino- AmericanConsortiumfortheAdvancementofChineseMedicinewhichwasmade up of the Ohio University in Athens, Ohio, Beijing University of CM, Chengdu UniversityofTCM,ChinaAcademyofChineseMedicalSciences,GuangzhouUni- versity of TCM, Heilongjiang University of TCM, Hong Kong Baptist University, NanjingUniversityofTCM,Shandong UniversityofTCM,andShanghai Univer- sityofTCM,TheBeijingUniversityofCMwastheleadinstitutionofthisproject. Itgatheredexpertsfromthememberinstitutionstocompiletheseriesandtranslate it into English which is now known as Essentials of Chinese Medicine. This text- bookseriescontainsthreevolumes:Volume1FoundationsofChineseMedicine; Volume2,ClinicalFundamentalsinChineseMedicine;andVolume3Essentials oftheClinicalSpecialtiesinChineseMedicine.Thesevolumessystematicallyin- troduce the basic theories, the diagnostic methods, the therapeutic methods based onsymptomdifferentiation,andtheknowledgeofprinciplesofhealthpreservation andrehabilitation.Theyexplainthebasicmethodsandtheoriesofacupunctureand moxibustion,aswellasexpoundingupon154kindsofChineseherbs;eachChinese medicinalherbisillustrated.Thetextbooksalsointroduce84Chineseherbalformu- lasand11associatedformulascommonlyusedinclinicalpractice.Furthermore,it elucidatestreatmentsofcommonlyandfrequentlyencountereddiseasesininternal medicine,surgery,gynecology,pediatrics,ophthalmologyandotorhinolaryngology. In the arrangement of contents and compilation, the following features charac- terizethistextbookseries: 1.EmphasisonthebasicknowledgeofCM Medical students who want to learn CM, especially students in western countries, need to adapt CM to Western medical terms and conditions, but this adaptation can only take place on the solid foundation of the theories of CM. There can be no mastery of CM without a true understanding of the theories and practice of CM. The first volume introduces the terminology and methodology of Chinese medicine in order to improve the critical thinking of medical students Preface ix and practitioners. It also contains a detailed explanation of the basic theories. The second volume covers the fundamentals of clinical practice. The more solid the foundation is, the easier it will be to have a better understanding and mastery ofCM 2.Conciseandsystematiccontent On the basis of developments of CM in education and research in the past, great effortshavebeenmadetohighlighttheessenceofCMthroughaccurateexposition and to introduce them to the world. These textbooks systematically introduce the basictheories,diagnosticmethods,acupunctureskills,knowledgeofChineseherbs, knowledgeofformulas,aswellasclinicalapplication.Masteryofthesetextbooks willlayafoundationforthefurtherstudyofCM. 3.Suitabilityforteachingandself-study Inthistextbookseries,attheendofmostchaptersguidanceisprovidedontheaims of study, the objectives of study and exercises for review. The structure combines thefeaturesoftextbooksandmodularhandbooks.Therefore,itishighlysuitablefor self-studybymedicalstudents. 4.Reinforcingeffectsofillustrations To facilitate the understanding of CM, the textbook series contains many illustra- tions. There are black and white photographs, line graphs, tables in the text with necessary indexes, color photographs of the tongue, and color photographs of 151 Chineseherbs.TheseillustrationsprovideabetterappreciationofCMandpromote itslearning. 5.Casestudies InVolume3andPartIIIofVolume2eachsectioncontainsasuccessfulcasestudy. ThesecasestudiesenhancetheunderstandingofCM. 6.Standardization Thistextbookseriesisreasonableinstructureanddistinctincategorization.Mostof thetechnicaltermsofCMhavebeenstandardizedintranslationwithanindexglos- sary.Simultaneously,habitualtermsusedincountriesusingEnglishasthemother tonguehavebeenconsideredinthetranslationandcompilation. x Preface In order to ensure academic standards and an accurate English translation of thistextbookseries,weinvitedinternationalexpertsoftheCMprofessionandthe EnglishlanguagetoreviewandrevisetheEnglishtranslation. ProfessorZhengSouzeng,theformerPresidentofBeijingUniversityofChinese Medicine,wastheDirectoroftheCompilationBoard.Dr.WarnerFanoftheUnited StatesistheEnglishConsultantwhohasgonethroughthewholetexttoensurethe languageconsistencythroughoutthetext. InternationaladvisorsinvitedincludeRyanThompsonfromCanada,IoannisSo- los from Greece and Georgia Ross from the United States of America. They and others have given much help in the compilation of this series of books. We are gratefultothemforveryusefulsuggestionsandrevisions. NoteonConventionsUsedintheText SeveralconventionsofusagehavebeenadoptedintheEnglishversionofthistext- book,andareintendedtomakethestudents’taskeasier. A number of concepts in traditional Chinese medicine cannot be adequately translated. The terms representing them are therefore presented in transliteration, usingthePinyinsystem.Wherethetermisalreadyincommonusagebutinthistext are used as technical terms, they are capitalized. Examples include Qi, Yin, Yang, theFiveElements(Metal,Wood,Water,Fire,Earth),thesixexogenouspathogenic evil (Wind, Heat or Summer Heat, Cold, Phlegm, Dampness, Fire) and their en- dogenouscounterparts,alltheacupoints,thefourLevels(Defensive,Qi,Nutritive, andBlood),etc.Wherethereisnoriskofconfusionbetweenordinaryandtechni- cal usage, they are not capitalized. Examples include the zang and fu organs, the sanjiao,etc. InthediscussionofCMmateriamedica,allmaterialsarereferredtoas“herbs,” even though many are derived from animal or mineral sources. This is the time- honored approach, as comparable medieval European books are often entitled “Herbals.” In traditional CM, herbs are seldom prescribed alone. A prescription is referredtohereasa“formula.” In addition, the name of each formula is given as one word, in pinyin transliteration of the Chinese name. In Chapter 7 of volume 2, which contains the main descriptions of the herbs, each entry is headed by the name of the herb in pinyin with its botanical name in brackets. The first line then gives the actual Chinese nameincharactersandtheherb’spharmaceuticalname(inLatin).Whenanherbis mentionedinthetextelsewhere,atitsfirstappearanceitisfollowedinbracketsby itsgenusnameifitisdescribedinChapter7ofvolume2orbyitsbotanicalname, bothgenusandspecies,ifitisnot.Itishopedthatdoingsowillmakeiteasierfor thestudentwhochoosestolookitupintheAppendixIII:HerbsorinChapter7of volume2.Whentheherbismentionedagaininthesamepassage,onlythenamein pinyinisgiven.